Clinical and behavioral correlates of achieving and maintaining glycemic targets in an underserved population with type 2 diabetes.
OBJECTIVE
In an underserved Latino area, we established a disease-management program and proved its effectiveness. However, many patients still remained above target. This study was designed to evaluate which factors are associated with reaching program goals.


METHODS
This was a randomized, prospective, observational study in which patients enrolled in our program were followed for 2 years with outcomes, measures, and questionnaires assessed at baseline and at 6, 12, and 24 months.


RESULTS
Overall, A1C fell by 1%. Adherence to medication was the strongest predictor of reaching the target A1C of <8%; baseline A1C was also predictive. Knowledge scores increased in those who reached target, but the measures of self-efficacy and empowerment did not change for either group.


CONCLUSIONS
Diabetes management is effective in a lower-income Latino population. However, adherence was suboptimal even when medications were provided on-site for free. Further research into barriers associated with medication adherence is needed.
Ruelas
Valerie
V
University of Southern California Keck School of Medicine, Los Angeles, California, USA.
Roybal
G Michael
GM
Lu
Yang
Y
Goldman
Dana
D
Peters
Anne
A
D001786:Blood Glucose / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy* / Q000534:rehabilitation; D005500:Follow-Up Studies; D006630:Hispanic or Latino; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D015141:Los Angeles; D008507:Medically Underserved Area; D008687:Metformin / Q000627:therapeutic use; D016017:Odds Ratio; D010349:Patient Compliance; D011203:Poverty; D013997:Time Factors
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin